Provider Demographics
NPI:1851361182
Name:NOVAK, LUCIA MARIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:LUCIA
Middle Name:MARIA
Last Name:NOVAK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11619 HITCHING POST LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4403
Mailing Address - Country:US
Mailing Address - Phone:301-693-3392
Mailing Address - Fax:878-201-5737
Practice Address - Street 1:2101 MEDICAL PARK DR STE 211
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4053
Practice Address - Country:US
Practice Address - Phone:301-836-9900
Practice Address - Fax:301-836-9910
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2020-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR141911363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FN 055 0815OtherDEA